WHITING — Eastern equine encephalitis, the new normal, is back.
For the second consecutive summer, the EEE virus has been detected in area mosquitoes, and health officials are urging vigilance against mosquito bites.
Vermont Health Department officials issued a statement Aug. 9 saying that the EEE virus was detected in Whiting in a mosquito pool collected on Aug. 1. It is the first time the virus has been detected in area mosquitoes this summer, although in July there were three positive tests for the mosquito-borne West Nile virus — in Whiting, Pittsford and Leicester.
Both viruses are spread to humans and some animals through the bite of an infected mosquito. No human or animal cases have been reported to date in 2013.
“These detections confirm that both mosquito-borne viruses are circulating in Vermont again this year,” said Health Commissioner Harry Chen, MD. “EEE can be a very serious disease and, although the risk of getting infected is low, it’s not zero. No matter where you live — enjoy the outdoors but take precautions to fight the bite.”
The presence of EEE in particular raises the level of public concern locally after last year’s deadly debut of the virus. EEE showed up in Vermont for the first time in human beings last July and resulted in two deaths. Richard Breen, 87, of Brandon, and Scott Sgorbati, 49, of Sudbury both contracted EEE last summer and died.
In early September 2012, state health and agriculture officials made the difficult decision to do an aerial spraying of pesticide over the Brandon and Whiting area to kill adult mosquitoes and reduce the risk to the public health. No other human cases of the virus have been reported since.
Although EEE has only been detected in southern Addison and northern Rutland counties, health officials say it’s likely the virus is present in other parts of the state. However, resources limit the state to testing only in the Whiting and Brandon area where the risk is highest. West Nile virus has been documented since 2000, and over the years has been detected in every county in Vermont. Officials hope that an improved surveillance plan and public vigilance will help prevent any human cases of EEE this year.
EEE and West Nile virus are considered arboviruses, meaning they are spread through the bite of a mosquito. The Health Department’s Arbovirus Surveillance Program was improved and expanded over the winter and spring thanks to increased attention from area legislators and an infusion of funding from the state. A budget increase of $331,500 from the FY2014 General Fund allowed for the hiring of additional field technicians and improved lab and testing resources. The increase brought the total funding for mosquito control and surveillance to $471,500, plus $25,000 in anticipated funding from the Vermont Department of Health. The total arbovirus surveillance budget includes an additional $175,000 in funding for local mosquito control districts, $89,500 for a vector coordinator to oversee specific areas of mosquito testing, and $144,000 for aerial spraying of adult mosquitoes should a public health risk be detected.
TESTING, TESTING
So far, officials have only found the EEE virus in one species of mosquito, the Culiseta melanura, which lives only in hardwood, acidic swamps and feeds primarily on birds. There is a large hardwood swamp in Whiting between Routes 30 and 7.
State Entomologist Alan Graham said he and his field technicians will start testing mosquitoes in Whiting twice a week now that EEE has been detected, as well as in Leicester, Brandon, Cornwall, Sudbury and Leicester.
“We’re trying to cover as many towns in the high-risk area as possible,” he said in a phone interview Monday. “We’re getting faster and faster every week.”
The good news is that while the Aug. 1 pool tested positive for EEE, a pool collected on Aug. 5 tested negative, Graham said.
Erica Berl, a Department of Health epidemiologist, said on Monday that mosquito testing at a new in-state lab facility will begin this week. Up until now, samples were being sent to a New York state lab.
The most controversial aspect of the area’s new normal is when to deploy aerial pesticide spraying. The state’s official procedure regarding aerial spraying is to do so only after there two to three weeks of consecutive positive EEE tests in area mosquito pools, but hopefully before any human cases. Many area residents would like to see the state be more pre-emptive, spraying before EEE is even detected in mosquitoes. On the other side of the issue are those who are concerned about powerful pesticides being sprayed on organic farms and gardens, and on livestock, and the effects the pesticide may have on Vermont’s treasured environment.
People who are infected with EEE can develop two types of illness. One has a sudden onset and is characterized by chills, fever, malaise, and joint and muscle pain, and lasts about one to two weeks. The more severe illness affects the central nervous system and causes fever, headache, irritability, restlessness, drowsiness, convulsions and coma. Approximately one-third of people with severe EEE die from the disease, although right now, Vermont’s mortality rate is 50 percent.
But EEE is so rare that there have only been 300 documented cases in the U.S. over the last 50 years, and only a few cases are reported each year, according to the Centers for Disease Control.
IT’S PERSONAL
Steve Sgorbati doesn’t like the odds, an opinion based on tragic, firsthand experience. His brother Scott contracted Vermont’s first human case of EEE last summer. He held on for five weeks in the intensive care unit at Fletcher Allen Health Care in Burlington before he died on Sept. 18.
“No one likes spraying,” Sgorbati said on Monday. “I don’t like it, but I don’t think it’s a good plan to sit back and wait until somebody gets sick.”
Sgorbati said this was about the time his brother was bitten by an infected mosquito last summer. He said he saw his brother the day before he started to feel ill and he was fine. That night, he developed a headache. The next morning, Scott Sgorbati still felt ill and by the afternoon developed a high fever.
“By the time we got home that night, he was not doing well,” Steve said.
On Aug. 16, 2012, Steve said, his brother had lapsed into a coma.
Last year, the state spent $140,000 on aerial spraying covering 72,000 acres, money that was not in the state’s budget. The cost is one reason why officials are hesitant to play the aerial spray card until there is a definitive public health risk. But Sgorbati said there is no price on human life.
“What is the cost of one day in the ICU?” he asked. “My brother was in the ICU for five weeks. I would have liked to see aerial spraying three weeks ago, when they knew it was coming. If they had, maybe there wouldn’t be a positive test now.”
But Berl and Graham reiterated that aerial spraying is just one tool in the state’s arsenal against arbovirus, and that personal protection is still the best way to prevent mosquito bites.
“We’re doing the best we can,” Graham said. “We have an early detection system and it’s working, but people still need to consider personal protection. Even with aerial spraying, there is no way the state can eradicate mosquitoes.”